G2 Works Analytics Solutions: RAC Audits

In 2010, CMS established the Recovery Audit Contractor (RAC) program to identify and correct improper payments made by Medicare and Medicaid. After a brief suspension in 2014, the program is back – with RAC contractors re-tooled and ready to audit your Medicare claims data.

Is your facility prepared?

G2 Works offers analytical services to help you collect and retain 100% of your Medicare reimbursement dollars (that’s a potential of $10,144 per claim). We track your clinical documentation; translate the data into actionable information; and proactively notify clinical leadership of issues that could negatively impact your facility in the event of an RAC audit.

Best of all, we access the systems you already have in place, so there’s no need for new technology purchases or cumbersome changes to workflows!

RAC Audits: Did you know??

    • They’re coming: 9 out of 10 hospitals have reported RAC audit activity
    • Auditors find far more Medicare overpayments than underpayments:
      • Overpayments reported in first quarter of FY 2014: $588.4 Million
      • Underpayments reported in first quarter of FY 2014: $64.5 Million
    • They make mistakes: When appealed, more than 70% of claims denials are overturned

Key Services

    • Assess your clinical workflow and map critical data elements for measurement and clinician intervention.
    • Continuously validate data quality and integrity.
    • Conduct weekly data reviews to identify clinical intervention as needed.
    • Identify and alert leadership of ongoing trends or issues in the data that suggest need for changes in process or compliance.
    • Continuously monitor dollar value of intervention and process changes.

Want to learn more about G2 Works Analytics Services?

Call 888.310.0733 or email us at info@g2works.com.